Friday, January 28, 2011

Analysis #3 - Put Your Money Where Your Brain Is


The human brain has always managed to fascinate us through its complex functions, mechanisms of communications, and storage of mass amounts of information. Compared to other animals, humans have the largest brain to body size ratio, making the human brain one of great interest to scientists and researchers alike. Advances in technology as well as biomedicine have provided us with new tools that have helped to expand our knowledge and understanding of the human brain and how it works. Studies on the human brain, like any other scientific study, tend to focus on viewing the human brain through an objective lens. This may be ideal in studies dealing with measurable or quantifiable components of the brain's functions (i.e. the damaging effects of alcohol on irreplaceable brain cells), but it may not be the most appropriate to apply in studies involving mental or psychiatric illness as the latter is based on the subjective experiences of the patient and is thus harder to physically detect by strictly objective biomedical standards. Objectifying human experiences with mental illness, which may be problematic as it tends to oversimplify the various sociocultural factors involved in its creation, is the controversial talk among scholars today and is the focus of this analysis.

The above image, from the Bioinformatics team at Becker Medical Library (http://beckerinfo.net/bioinformatics/?p=675), is a cartoon that depicts two frames illustrating how we see ourselves and how our professors see us. (I have extended the term "professors" to encompass a broader category of professionals including professors, medical professionals, researchers, scientists, etc.) The left cartoon frame portrays us as being "complex human beings" with "hopes, dreams, and aspirations". The right cartoon frame, however, portrays us as being seen simply as a brain on a stick whose sole purpose is to contribute to science (through research, for example). The way this cartoon portrays humans as merely "brains on a stick" may seem like a crude joke to some, yet I find a great deal of truth hidden amidst the sardonic humor behind this cartoon. It seems that in recent times, with the onset of technological and medical advances, scientists and researchers have been dangerously eager to place a blanket of objectivity over humans and the experiences we face as complex human beings. Simon Cohn discusses this emphasis on objectivity in his piece on "Picturing the Brain Inside, Revealing the Illness Outside: A Comparison of the Different Meanings Attributed to Brain Scans by Scientists and Patients". In examining the effects of brain scan images to both scientists and patients, Cohn states that "for the neuroscientists, making images is ostensibly about doing science - gaining objectivity through the identification of definitive material things without having to resort to the messy external subjectivity of a behaviour-based classification of disease" (Cohn, 66). The term "messy" used in this context carries with it a negative connotation, suggesting that any subjective factors involved in mental or psychiatric illness are bothersome, overly complicated, and in the need of organization or even complete removal.

Patients who voluntarily participate in the research study outlined in Cohn's article receive "a copy of the scan to take home as a kind of thank you gift" (Cohn, 74). The copy of the brain scan has profoundly different meanings for the scientists and the patient. While "the researchers perceive the value of the scans only in terms of the work in the lab, and view giving the patients a copy merely a contractual duty with no other consequence or significance" (Cohn, 67), the patients view the scans as a way to "legitimize their conditions in a new way and make them 'real'" (Cohn, 67). Again, the scientists' attitudes of indifference towards the copies of the brain scans demonstrate how they value the organ only for the objective information it can provide to their research and not to the subjective or personal experiences of the patients. Cohn continues on to state that we live in an era in which "new biological knowledge is being used as the grounds for individual identities and forms of sociality" (Cohn, 68), forcing people to develop and organize relationships with others "through technologies that divide and categorize" (Cohn, 68). This process of separation and categorization is partly responsible for the behavior of the patients who take home copies of their brain scans to show others in an effort to "redefine the whole well self from the diseased part" (Cohn, 75). This need to "re-conceptualize their suffering" (Cohn, 74) rests on the patients' desire to objectively "demarcate mental from physical illness" (Cohn, 75) by locating the physical source of the illness on the brain scan. Patients would do this in the hopes of authenticating their conditions and labeling them as "a social object" that is separate from the person behind the mental illness. The use of the processes of brain scans to diagnose mental illnesses such as schizophrenia "have shifted from the realm of human subjectivity and interaction to one of apparent objectivity via the hardware and the vastly complex mathematical algorithms used to identify brain abnormality" (Cohn, 76). In this sense, we have grown to ignore the importance of sociocultural determinants of health and have instead shifted to a much more narrow, objective view of illness.

Much like scientific objectivity has affected studies on brain functions and their relations to mental illness, cultural ideology has also shaped our views on various psychiatric disorders. In his piece titled "A Description of How Ideology Shapes Knowledge of a Mental Disorder (Posttraumatic Stress Disorder)", Allan Young discusses the role of ideology in the production of knowledge. The Institute for the Treatment of Posttraumatic Stress Disorder emphasizes on "its division of mental labor" (Young, 117) and the need for the therapists and staff "to behave as if they believe the ideology's propositions are true" (Young, 126). Like the patients in Cohn's article, who hope for a cure to their now physically and objectively defined mental illnesses, the veterans who suffer from PTSD in Young's article hope to "[exculpate] themselves of moral responsibility for their present state", which they can now classify as exhibiting "sickness without psychosis - an attractive idea to someone who fears he is going crazy or who was once diagnosed as psychotic" (Young, 127). Both articles demonstrate how patients, despite being aware that objectifying their experiences downplays the importance of their subjective experiences, strive to use objectively conceptualized definitions of their mental illness in order to separate themselves from their psychiatric conditions. The patients may feel this need to "prove" themselves to others within various social spheres since "in the end it required the recognition and affirmation of others as much as the [patients] themselves" (Cohn, 79). Science's emphasis on pure objectivity without the influence of subjective experiences and society's focus on social acceptance both play crucial roles in shaping discourses on health and illness. This in turn may have a huge impact on the ways we view humans as both people and as pure subjects of study. Such views can present implications of how and where biomedicine may lead us in the future.

 Works Cited:

Cohn, Simon. 2010. “Picturing the Brain Inside, Revealing the Illness Outside: A Comparison of the Different Meanings Attributed to Brain Scans by Scientists and Patients”. Pp. 65-84. Technologized Images Technologized Bodies. Edited by Jeanette Edwards, Penny Harvey, and Peter Wade. New York: Berghahn Books.

Young, Allan. 1993. “A Description of How Ideology Shapes Knowledge of a Mental Disorder (Postraumatic Stress Disorder)”. Pp. 108-128. Knowledge, Power, and Practice: The Anthropology of Medicine and Everyday Life. Edited by Shirley Lindenbaum and Margaret Lock. Berkeley: University of California Press.

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